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�.,.x _ <br />:_ai��'ne�J7l <br />PUBLIC WORKS PERMIT Date 12I28I2011 <br />Ciry of Everett Fubl�c Works DepattmentFf;I1 l�:�bPublic Works Permit #: PW1112-010 <br />3200Gedar Streel ;'EG-1 ��J4<JI Buildinp Permit #: <br />Everett. WA 98201 �f Pl�anning Reference #. <br />( 4 23 )<2.5.7 ?8 81:0. �' �11 U <br />Public Works Fee S: S 45.00 <br />1 OiHEF: <br />.` <br />OWNER NAME AND ADDRESS: f;N!��: <br />KIM BERGESEN <br />320 TAMARACK DR <br />EVERETT WA 98203 <br />PHONE: 425344599Fi <br />AX PARCEL ID # <br />DESCRIPTION OF PROPOSED WORK: <br />DRIVEWAY EXTENTION <br />(12/28/2011 11:30 AM BES) <br />DRIVEWAY EXTENTION TO THE GARAGE AT THE BACK <br />i4�.Gii <br />Olher 5: <br />APPCIGA'NT NAME AND AODRESS: <br />SAfv1E <br />PHONE: <br />SITE ADDRESS: 320 TAMl�RACK BR+V�,q.UL <br />PERMIT CONDITIONS <br />1 All calls tor inspection shall he made 24 hours m advance. <br />2. All work shall be performed in accordance with the permit and current City of Everett Design and Construction Slandards <br />and Speufications. <br />3 Call Location Underground Sernce 4E hrs before you dig. TOLL FREE NUMBER 611 � <br />4. NO DIRT, MUD, ROCKS OR DEBRIS TRACKED ONTO ROADWAY <br />5. CONSTRUCT PER APPROVED PIAN. W <br />6 CALL INSPECTOR RANDY ALLEN 425•339•7403 BEFORE <br />START OF CONSTRUCTION. F <br />S�ti���� ��'�,� �,�d�s <br />t! <br />�er <br />1' <br />�Z <br />for <br />k� � <br />►r <br />� <br />Q� <br />� <br />r�., <br />z <br />0 <br />�- <br />� <br />0 <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned o�vnedapphcaN hcreby agrecs ro hold and <br />save harmless the Gty of Everett Irom any and all claims for <br />damages. costs, expenses, or causes ot action that may arise <br />because of installation and malrlenance of the improvemen� <br />or other right-of-way use hereto applied for and furiher agrees <br />to remove same upon notice from the City and to �eplace <br />public property damaged thereby <br />'[CTION Date I `�� � � 13� ��U �I <br />as Constructed Signalure of Applicant Date <br />WORK AUTHORIZ[D BY THIS PERhiR h1U5T BE STARTED WRHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENT�Y <br />PURSUED TO CCMPLtT10N. TFi15 PERMR h1AY BE CANCELIED BY THE CfTY UPON ANY STOPPAGE OF WORK ON THIS PRO]ECi OVER 90 DAYS OURATION. <br />